KATRINA J SMITH (NPI# 1689964462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689964462 |
| Entity Type | Individual |
| Full Name | KATRINA J SMITH |
| Credential | P.A. |
| Practice Address |
4215 Edgewater Dr Orlando FL 32804-2206 |
| Mailing Address |
Po Box 4059 Wayne NJ 07474-4059 |
| Practice Telephone | 9738268080 |
| Practice Fax Number | 8889726480 |
| Mailing Telephone | (973) 826-8080 |
| Mailing Fax Number | 8889726480 |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2017-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9105946 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | QSS SCS PTAN | FB469U | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114486768 | Katrina Smith | Occupational Therapist | 44 N 300 E, Provo, UT 84606-3211 | 2019-03-13 |
| 1619479516 | Katrina Reanne Smith | Specialist/Technologist | 237 Prevost Rd, Cloquet, MN 55720-9420 | 2018-03-06 |
| 1063954899 | Katrina Smith | Chiropractor | 2050 Oleander Blvd, 8-201, Fort Pierce, FL 34950-5334 | 2016-11-10 |
| 1699179853 | Katrina Smith | Specialist/Technologist | 1 Indian Trl, Piqua, OH 45356-9257 | 2014-10-17 |
| 1063779692 | Katrina Smith | Mechanotherapist | 1712 Coe Rd Sw, Albuquerque, NM 87105-7025 | 2012-04-20 |
| 1831713353 | Katrina Smith | Occupational Therapist | 410 New Bridge St Ste 10a, Jacksonville, NC 28540-4700 | 2020-06-01 |
| 1700421591 | Katrina Joyce Smith | Licensed Practical Nurse | 2025 S Washington Ave Ste 210, Lansing, MI 48910-0817 | 2019-11-15 |
| 1114576543 | Katrina Mae Smith | Nurse Practitioner | 1101 26th St S, Great Falls, MT 59405-5161 | 2019-09-09 |
| 1083175129 | Katrina Smith | Occupational Therapy Assistant | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-03-29 |
| 1740766336 | Katrina Elaina Smith | Audiologist | 1001 James St, Syracuse, NY 13203-2789 | 2018-07-17 |
| Street Address |
4215 EDGEWATER DR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32804-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225022239 | John Leslie Steele | Physician Assistant | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2005-09-06 |
| 1518369578 | Brett Young | Specialist/Technologist, Other | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2014-09-22 |
| 1740521137 | Qss-southeast Clinical Services LLC | Surgery | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2013-03-08 |
| 1972844660 | Nicole Moskal | Physician Assistant | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2013-03-06 |
| 1083968820 | Denise Livingston | Nurse Practitioner | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2012-11-01 |
| 1932456985 | William Lee Earp IIi | Specialist/Technologist, Other | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2012-08-09 |
| 1497901029 | Anthony Allen Moore | Physician Assistant | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2008-08-14 |
| 1518160779 | Stephen E Mcnally Sr. | Specialist | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2007-06-06 |
| 1295876969 | Gueorgui T Maltchev | Physician Assistant | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2007-02-08 |
| 1972653160 | Diana K Marl | Physician Assistant | 4215 Edgewater Dr, Orlando, FL 32804-2206 | 2007-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881252716 | Alyssa Bass | Counselor | 3130 Edgewater Dr, Orlando, FL 32804 | 2019-06-05 |
| 1841856366 | Debora Cheryl Ramirez | Technician/Technologist | 1231 North Orange Ave, Orlando, FL 32804 | 2019-05-10 |
| 1679074009 | Jessica Dobbs | Counselor | 3801 Grant Blvd, Orlando, FL 32804 | 2018-02-21 |
| 1881109031 | Pedro Mendez Jr. | Counselor | 1800 W. Colonial Drive, Orlando, FL 32804 | 2017-12-11 |
| 1902259310 | Michael Lo | Nurse Practitioner | 2400 N Orange Ave Ste 302, Orlando, FL 32804 | 2016-07-20 |
| 1083093595 | Michael Gregg | Student in an Organized Health Care Education/Training Program | 2415 North Orange Avenue, Suite 400, Orlando, FL 32804 | 2015-05-29 |
| 1922485473 | Lindsay Rae Piet | Physician Assistant | 1910 N. Orange Ave., Orlando, FL 32804 | 2015-05-05 |
| 1093106189 | College Park Community Acupuncture & Herbal Medicine | Acupuncturist | 710 W. Princeton Street., Suite A, Orlando, FL 32804 | 2015-02-10 |
| 1164822359 | Orlando Sleep Solutions, LLC | Durable Medical Equipment & Medical Supplies | 2921 N. Orange Ave, Orlando, FL 32804 | 2014-08-26 |
| 1780926741 | Joseph Arturo Reza | Student in an Organized Health Care Education/Training Program | 2415 N Orange Ave #400, Orlando, FL 32804 | 2013-03-17 |
| Find all providers in zip 32804 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| 1750843405 | Heather Louise Anderson | Physician Assistant | 5422 Lewiston St, Orlando, FL 32812 | 2019-04-02 |
| 1649600891 | Raul F Velez | Physician Assistant | 14139 Budworth Cir, Orlando, FL 32832-6123 | 2013-11-24 |
| 1255630075 | Joleen Chapman | Physician Assistant | 122 Annie St, Orlando, FL 32806-1214 | 2011-03-18 |
| 1124354600 | Tiffany M Murray | Physician Assistant | 83 W Copeland Dr, Orlando, FL 32806-2002 | 2009-10-19 |
| 1225277825 | M Catherine Broderick | Physician Assistant | 1720 S Cook Avenue, Orlando, FL 32808 | 2009-02-05 |
| 1033360938 | Monica M Rivera | Physician Assistant | 2591 Carrickton Cir, Orlando, FL 32824-4217 | 2008-10-09 |
| 1316104383 | Michele D Young | Physician Assistant | 3802 Oakwater Cir Ste 3, Orlando, FL 32806-6200 | 2008-05-19 |
| 1033162011 | Southeastern Clinical Services,inc. | Physician Assistant | 4215 Edgewater, Orlando, FL 32804 | 2006-05-18 |
| 1386696631 | Kevin P Kingsley | Physician Assistant | 2501 N Orange Ave Ste 411, Orlando, FL 32804-4644 | 2006-05-16 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.